1983, 02-04 Permit: 83A-0850 MHPLAN NUMBER" APPLICATION/PERMIT
SPOKANE COUNTY -'BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK • Enum. Dist. Location (Area)
8• S SID CGU FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WAVER SEWER
Ownership USE CODE
9. 32 UTILOITIES 57151"/ /i -Public ❑ Private ❑ Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF AP`LICATION 7" tJ� SIGNATURE OF APPLICANT O yL'0 — Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: I Plan Check
NAME DATE
Env. Health A,
Planning
Fire Marshall
C sneer
Utilities
Plans Examiner
1110 APP oACH P"qir RE&W165D AT T9JS T/Mc
,!!�TAAJDAkb APPRWIAI &&"j co AT TIM,= or
6-A,eA&, G' 1VS7j?U&7'joA! W1rH j,,j GK/E 11 F e
Fgr)44 DA's oc pue-e-h4A-S,6 .
SEPA
Mobile Home �v
Other (Specify)
TOTAL $ K/v
r E A MnFi UMBER
A
07* * 1 C' OG
*100�G
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
ch is an PERMIT IS NONTRANSFERABLE 0�2 �' - 8' 3 8'S, z *`1 0 a
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
0
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APPLICANT: COMPLETE NUMBERED SPACES - PRESS
HARD TO MAKE 3 COPIES
� •
JOB ADDRESS
E 1$ Til
% A he vii '
LEGAL DESCRIPTION - SEE ATTACHED
LOT
4
I BLOCK
�2—
ISUBDO
L
PARCEL NUMBER/S ^�
OSSSZ — 150 4
2.
O C' H - /-1"E
=s
OWNER
Aqui-
Gib
PHONE
BL TF
3.
-L d!55
ADDRESS
ZIP
Actual Set Backs in Feet
G , 19711
't T� ��
AhYIE0 i. �J//
S
d.2.
�),J
North South `14 East 10 West 40
C NTRACTOR
&
PHONE
194-
Size of Parcel
Zone Classification
-
-
�
171
!� 1I
i,L16 E
a,
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
11-3
❑Yes ❑No ❑ Req -d.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE
FROM
TO
Area of Decksished
FinBasement Unfin, Basement
6.
XV19
�,/
TYPE I/y NEW
/
EIALT. ❑ AWN.
❑ RPL.
❑ MVE.
No. Baths
No. Stories
No. ooms
No. of Dwellings
1
7,
OF
1:1 BLD.
❑ PLMB. ❑ MECH.
M.H.
❑ OTHER
❑POOL
CERTIFICATE
Req'd.
Recd.
t Req'd.
WORK
I
of EXEMPTION
IN
DESCRIBE WORK • Enum. Dist. Location (Area)
8• S SID CGU FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WAVER SEWER
Ownership USE CODE
9. 32 UTILOITIES 57151"/ /i -Public ❑ Private ❑ Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF AP`LICATION 7" tJ� SIGNATURE OF APPLICANT O yL'0 — Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: I Plan Check
NAME DATE
Env. Health A,
Planning
Fire Marshall
C sneer
Utilities
Plans Examiner
1110 APP oACH P"qir RE&W165D AT T9JS T/Mc
,!!�TAAJDAkb APPRWIAI &&"j co AT TIM,= or
6-A,eA&, G' 1VS7j?U&7'joA! W1rH j,,j GK/E 11 F e
Fgr)44 DA's oc pue-e-h4A-S,6 .
SEPA
Mobile Home �v
Other (Specify)
TOTAL $ K/v
r E A MnFi UMBER
A
07* * 1 C' OG
*100�G
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
ch is an PERMIT IS NONTRANSFERABLE 0�2 �' - 8' 3 8'S, z *`1 0 a
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
0
C
c
T